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EPILEPTIFORM ATTACKS IN CASES OF GLIOMA OF THE CEREBRAL HEMISPHERES: RELATION TO THE LOCATION AND HISTOLOGIC TYPE OF THE GLIOMA

EPILEPTIFORM ATTACKS IN CASES OF GLIOMA OF THE CEREBRAL HEMISPHERES: RELATION TO THE LOCATION AND... Abstract Much has already been written concerning epileptiform seizures in cases of intracranial neoplasm. In most reports the frequency and type of epileptiform attacks are discussed in reference to the location of the tumor (Parker, Gibbs); little or no attention has been paid to the histologic type of the lesion. This kind of approach has been attempted only by R. Groff, in a recent contribution discussing epileptic attacks in cases of meningioma. Of late it has been recognized that lesions situated in certain cerebral areas do not always produce a constant neurologic syndrome and that the clinical signs may vary in accordance with the histologic nature of the disease (Bailey and Cushing). From this point of view I have analyzed the frequency and type of epileptiform attacks in cases of glioma. Special consideration has been given to the clinical symptomatology of the various subgroups of glioma. MATERIAL This paper is based References 1. In this paper the term frontal will be used only for the region anterior to the precentral gyrus. Lesions occupying chiefly the rolandic and postrolandic gyrus will be listed as gliomas of the frontoparietal region. 2. In a few cases there was some doubt as to the type, duration and frequency of the epileptiform attacks. This may have been due to insufficient information or inadequate observation by the patient or his relatives or may have been caused by an incomplete medical investigation. The fact that the neurologist or the neurosurgeon often has no opportunity to observe the attacks may account for this. 3. I am not including here the hallucinations observed in many cases of purely psychiatric conditions. 4. The ratio of the number of cases in which epilepsy occurred to the number in which it did not occur will be referred to in this paper as the epilepsy index. 5. Deficiency symptoms are those due to loss of function dependent on the destruction of nerve tissue. 6. Only calcifications visible in the roentgenograms are considered here. 7. The presence of a meningioma should also be considered and can be recognized, in many instances, from roentgenograms. 8. In such cases a metastatic tumor of the brain must be ruled out. 9. Alajouanine, T.; Petit-Dutaillis, D.; Bertrand, I., and Ducas, P.: Tumeur volumineuse de la région paracentrale (aspect spécial de gliome extériorisé et pédiculé); ablation chirurgicale , Rev. neurol. 2:709, 1928. 10. Alajouanine —Petit-Dutaillis, D.; Bertrand, I., and Schmite, P.: Étude comparative de quatre cas de tumeurs de la région rolandique , Bull. et mém. Soc. méd. d. hôp. de Paris 54:1672 ( (Dec. 1) ) 1930. 11. Allen, I. M.: A Clinical Study of Tumors Involving the Occipital Lobe , Brain 53:194, 1930.Crossref 12. Bailey, P.: Intracranial Tumors , Springfield, Ill., Charles C. Thomas, Publisher, 1933. 13. Bailey and Bucy, P. C.: Oligodendrogliomas of the Brain , J. Path. & Bact. 32:735, 1929. 14. The Astroblastomas of the Brain , Acta psychiat. et neurol. 5:439, 1930. 15. —and Cushing, H.: A Classification of the Tumors of the Glioma Group on a Histogenetic Basis, with a Correlated Study of Prognosis , Philadelphia, J. B. Lippincott Company, 1926. 16. —Sosman, M. C., and Van Dessel, A.: Roentgen Therapy of the Gliomas of the Brain , Am. J. Roentgenol. 19:203, 1928. 17. Courville, C. B., and Adelstein, L. J.: Intracranial Calcification, with Particular Reference to That Occurring in the Gliomas , Arch. Surg. 21:801 ( (Nov.) ) 1930. 18. Crouzon, O., and Oberling, C.: Les gliomes protoplasmiques pseudo-papillaires (Neuro-épithéliomes gliomateux. Epithéliogliomes) , Rev. neurol. 1:1199, 1929. 19. Cushing, H.: Intracranial Tumors , Springfield, Ill., Charles C. Thomas, Publisher, 1932. 20. Delagenière, Y., and Hombourger, P.: Tumeur cérébrale de la région frontale à symptomologie de tumeur de l'infundibulum , Rev. neurol. 1:1251, 1930. 21. Divry, P., and Christophe, J.: Trois cas de gliome cérébral , J. de neurol. et de psychiat. 31:509, 1931. 22. Divry Christophe, L., and Moreau, M.: Glioblastome du lobe temporal gauche et encéphalite périaxiale diffuse , Rev. neurol. 2:113, 1932. 23. Dowling E.; Orlando, R., and Kuhn, M. I.: Spongioblastoma Multiforme of the Right Temporal Lobe , Rev. argent. de neurol., psiquiat. y med. leg. 4:99, 1933. 24. Elsberg, C. A., and Globus, J. H.: Tumors of the Brain with Acute Onset and Rapidly Progressive Course , Arch. Neurol. & Psychiat. 21:1044 ( (May) ) 1929. 25. Fincher, E. F., Jr., and Coon, G. P.: Ependymomas: A Clinical and Pathologic Study of Eight Cases , Arch. Neurol. & Psychiat. 22:19 ( (July) ) 1929. 26. Fincher and Dowman, C. E.: Epileptiform Seizures of Jacksonian Character , J. A. M. A. 97:1375 ( (Nov. 7) ) 1931. 27. Foerster, O.: Die Pathogenese des epileptischen Krampfanfalls , Deutsche Ztschr. f. Nervenh. 94:15 ( (Dec.) ) 1926. 28. Foerster and Penfield, W.: Structural Basis of Traumatic Epilepsy and Results of Radical Operation , Brain 53:99 ( (July) ) 1930. 29. Gibbs, F. A.: Frequency with Which Tumors in Various Parts of the Brain Produce Certain Symptoms , Arch. Neurol. & Psychiat. 28:969 ( (Nov.) ) 1932. 30. Groff, R. A.: The Meningioma as a Cause of Epilepsy , Ann. Surg. 101:167, 1935. 31. Guillain, G.; Petit-Dutaillis, D.; Bertrand, I., and Lereboullet, J.: Oligodendrogliome de la région rolandique , Rev. neurol. 1:977, 1932. 32. Hartmann, M.: Ueber einen Fall von Tumor des rechten Schläfenlappens , Arch. f. Psychiat. 94:847, 1931.Crossref 33. Hauptmann, A.: Zur Symptomatologie der Erkrankungen des rechten Schläfenlappens , Deutsche Ztschr. f. Nervenh. 117-119:170, 1931.Crossref 34. Kennedy, F.: Epilepsy and the Convulsive State , Arch. Neurol. & Psychiat. 9:567 ( (May) ) 1923. 35. Kolodny, A.: The Symptomatology of the Tumors of the Temporal Lobe , Brain 51:385, 1928. 36. Symptomatology of Tumor of the Frontal Lobe , Arch. Neurol. & Psychiat. 21:1107 ( (May) ) 1929. 37. Kubitschek, P. E.: The Symptomatology of the Tumors of the Frontal Lobe , Arch. Neurol. & Psychiat. 20:559 ( (Sept.) ) 1928. 38. MacRobert, R. G., and Feinier, L.: The Cause of Epileptic Seizures in Tumors of the Temporosphenoidal Lobe , J. A. M. A. 76:500 ( (Feb. 19) ) 1921. 39. MacRobert and Hens, J. S.: Petit Mai and Aphasia , Tr. Am. Neurol. A. 55:562, 1929. 40. de Martel, T.; Guillaume, J., and Jentzer, A.: Tumeurs temporo-occipitales, dont une tumeur du ventricule latéral , Rev. neurol. 2:63, 1931. 41. de Martel and Vincent, C.: Les hallucinations visuelles dans les tumeurs temporales avec trois observations , Rev. neurol. 1:203, 1930. 42. de Martel Monbrun, A., and Guillaume, J.: Volumineuse tumeur frontale droite (astrocytome fibrillaire kystique). Absence de syndrome focal. Localisation établie par la ventriculographie , Opération. Guérison, Rev. neurol. 1:726, 1933. 43. Martin, J. P.: Two Cases of Oligodendroglioma , Brain 54:330, 1931. 44. Masson, C. B.: The Occurrence of Calcification in Gliomas , Bull. Neurol. Inst. , New York 1:314, 1931. 45. Moniz, E.: Tumeurs cérébrales visible chez les épileptiques , Rev. neurol. 37:18, 1930. 46. Opalski, A.: Un cas de tumeur de la zone cérébrale motrice avec hémiplégie homolatérale sans symptômes croisés , Rev. neurol. 1:369, 1931. 47. Parker, H. L.: Epileptiform Convulsions: The Incidence of Attacks in Cases of Intracranial Tumor , Arch. Neurol. & Psychiat. 23:1032 ( (May) ) 1930. 48. Penfield, W., and Gage, L.: Cerebral Localization of Epileptic Manifestations , Arch. Neurol. & Psychiat. 30:709 ( (Oct.) ) 1933. 49. Pritchard, E. A. B.: Cerebral Tumor as a Cause of Generalized Epileptic Attacks of Long Standing , Lancet 2:842, 1931. 50. Riggs, H. W.: Dangers and Mortality of Ventriculography , Bull. Neurol. Inst. , New York 3:210, 1933. 51. Rochon-Duvigneaud; Schaeffer, de Martel and Guillaume: Gliome frontal kystique droit sans aucun signe de localisation focale. Intervention opératoire. Guérison , Rev. neurol. 1:682, 1933. 52. Rouquier, A.; Lhermitte, J., and Trelles, J.: Hémiplégie de type du hystérique ou pithiatique, manifestation initiale d'un gliome du corps calleux. Etude clinique , Rev. neurol. 1:448, 1932. 53. Sargent, P.: Epilepsy , Brain 44:312, 1931.Crossref 54. Some Observations on Epilepsy , Proc. Roy. Soc. Med. (Sect. Neurol.) 15:1, 1922. 55. Schlesinger, B.: The Syndrome of the Fibrillary Astrocytomas of the Temporal Lobe , Arch. Neurol. & Psychiat. 29:843 ( (April) ) 1933. 56. Spiegel, E. A.: Rindenerregung (Auslösung epileptiformer Anfälle) durch Labyrinthreizung: Versuch einer Lokalisation der corticalen Labyrinthzentren , Ztschr. f. d. ges. Neurol. u. Psychiat. 138:178, 1932. 57. Stauder, K. H.: Epilepsie und Vestibular-apparat , Arch. f. Psychiat. 101:739, 1934. 58. Stone, L.: Paradoxical Symptoms in Right Temporal Lobe Tumor , J. Nerv. & Ment. Dis. 79:1, 1934. 59. Thomas, A.: Tumeur de l'extrémité antérieure du lobe temporal gauche , Rev. neurol. 2:207, 1928. 60. Urechia, C. I., and Retezeanu: Tumeur de la région temporo-occipitale avec crises de "dreamy state," Paris méd. 2:229, 1933. 61. van Bogaert, L.: Attaques de microtéléopsie, attaques uncinées par gliome temporale , J. de neurol. et de psychiat. 28:561, 1928. 62. Van Dessel, Arthur: L'incidence et le processus de calcification dans les gliomes du cerveau , Arch. franco-belges de chir. 28:845, 1925. 63. Van Gehuchten, P., and Morelle, J.: Tumeur du lobe frontal gauche avec aphasie transitoire , J. de neurol. et de psychiat. 31:135, 1931. 64. Vincent, C.: Diagnostic des tumeurs comprimant le lobe frontal , Rev. neurol. 1: 826, 1928. 65. Vincent and Darquier, J.: Tumeur du lobe frontal gauche. Des erreurs de localisation que peuvent entraîner certaines attitudes anormales de la tête , Rev. neurol. 1:758, 1931. 66. Vincent David, M., and Puech, P.: Sur l'aléxie. Production du phénomène à la suite de l'extirpation de la corne occipitale du ventricule latéral gauche , Rev. neurol 1:262, 1930. 67. Tumeur intraventriculaire droite comprimant les tubercules quadrijumeaux postérieurs. Ablation d'une très grande partie. Guérison , Rev. neurol. 1:644, 1930. 68. Sur l'ablation des tumeurs du cerveau par l'électro-coagulation unipolaire , Rev. neurol. 1:843, 1932. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology & Psychiatry American Medical Association

EPILEPTIFORM ATTACKS IN CASES OF GLIOMA OF THE CEREBRAL HEMISPHERES: RELATION TO THE LOCATION AND HISTOLOGIC TYPE OF THE GLIOMA

Archives of Neurology & Psychiatry , Volume 35 (2) – Feb 1, 1936

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American Medical Association
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Copyright © 1936 American Medical Association. All Rights Reserved.
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0096-6754
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10.1001/archneurpsyc.1936.02260020117010
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Abstract

Abstract Much has already been written concerning epileptiform seizures in cases of intracranial neoplasm. In most reports the frequency and type of epileptiform attacks are discussed in reference to the location of the tumor (Parker, Gibbs); little or no attention has been paid to the histologic type of the lesion. This kind of approach has been attempted only by R. Groff, in a recent contribution discussing epileptic attacks in cases of meningioma. Of late it has been recognized that lesions situated in certain cerebral areas do not always produce a constant neurologic syndrome and that the clinical signs may vary in accordance with the histologic nature of the disease (Bailey and Cushing). From this point of view I have analyzed the frequency and type of epileptiform attacks in cases of glioma. Special consideration has been given to the clinical symptomatology of the various subgroups of glioma. MATERIAL This paper is based References 1. In this paper the term frontal will be used only for the region anterior to the precentral gyrus. Lesions occupying chiefly the rolandic and postrolandic gyrus will be listed as gliomas of the frontoparietal region. 2. In a few cases there was some doubt as to the type, duration and frequency of the epileptiform attacks. This may have been due to insufficient information or inadequate observation by the patient or his relatives or may have been caused by an incomplete medical investigation. The fact that the neurologist or the neurosurgeon often has no opportunity to observe the attacks may account for this. 3. I am not including here the hallucinations observed in many cases of purely psychiatric conditions. 4. The ratio of the number of cases in which epilepsy occurred to the number in which it did not occur will be referred to in this paper as the epilepsy index. 5. Deficiency symptoms are those due to loss of function dependent on the destruction of nerve tissue. 6. Only calcifications visible in the roentgenograms are considered here. 7. The presence of a meningioma should also be considered and can be recognized, in many instances, from roentgenograms. 8. In such cases a metastatic tumor of the brain must be ruled out. 9. Alajouanine, T.; Petit-Dutaillis, D.; Bertrand, I., and Ducas, P.: Tumeur volumineuse de la région paracentrale (aspect spécial de gliome extériorisé et pédiculé); ablation chirurgicale , Rev. neurol. 2:709, 1928. 10. Alajouanine —Petit-Dutaillis, D.; Bertrand, I., and Schmite, P.: Étude comparative de quatre cas de tumeurs de la région rolandique , Bull. et mém. Soc. méd. d. hôp. de Paris 54:1672 ( (Dec. 1) ) 1930. 11. Allen, I. M.: A Clinical Study of Tumors Involving the Occipital Lobe , Brain 53:194, 1930.Crossref 12. Bailey, P.: Intracranial Tumors , Springfield, Ill., Charles C. Thomas, Publisher, 1933. 13. Bailey and Bucy, P. C.: Oligodendrogliomas of the Brain , J. Path. & Bact. 32:735, 1929. 14. The Astroblastomas of the Brain , Acta psychiat. et neurol. 5:439, 1930. 15. —and Cushing, H.: A Classification of the Tumors of the Glioma Group on a Histogenetic Basis, with a Correlated Study of Prognosis , Philadelphia, J. B. Lippincott Company, 1926. 16. —Sosman, M. C., and Van Dessel, A.: Roentgen Therapy of the Gliomas of the Brain , Am. J. Roentgenol. 19:203, 1928. 17. Courville, C. B., and Adelstein, L. J.: Intracranial Calcification, with Particular Reference to That Occurring in the Gliomas , Arch. Surg. 21:801 ( (Nov.) ) 1930. 18. Crouzon, O., and Oberling, C.: Les gliomes protoplasmiques pseudo-papillaires (Neuro-épithéliomes gliomateux. Epithéliogliomes) , Rev. neurol. 1:1199, 1929. 19. Cushing, H.: Intracranial Tumors , Springfield, Ill., Charles C. Thomas, Publisher, 1932. 20. Delagenière, Y., and Hombourger, P.: Tumeur cérébrale de la région frontale à symptomologie de tumeur de l'infundibulum , Rev. neurol. 1:1251, 1930. 21. Divry, P., and Christophe, J.: Trois cas de gliome cérébral , J. de neurol. et de psychiat. 31:509, 1931. 22. Divry Christophe, L., and Moreau, M.: Glioblastome du lobe temporal gauche et encéphalite périaxiale diffuse , Rev. neurol. 2:113, 1932. 23. Dowling E.; Orlando, R., and Kuhn, M. I.: Spongioblastoma Multiforme of the Right Temporal Lobe , Rev. argent. de neurol., psiquiat. y med. leg. 4:99, 1933. 24. Elsberg, C. A., and Globus, J. H.: Tumors of the Brain with Acute Onset and Rapidly Progressive Course , Arch. Neurol. & Psychiat. 21:1044 ( (May) ) 1929. 25. Fincher, E. F., Jr., and Coon, G. P.: Ependymomas: A Clinical and Pathologic Study of Eight Cases , Arch. Neurol. & Psychiat. 22:19 ( (July) ) 1929. 26. Fincher and Dowman, C. E.: Epileptiform Seizures of Jacksonian Character , J. A. M. A. 97:1375 ( (Nov. 7) ) 1931. 27. Foerster, O.: Die Pathogenese des epileptischen Krampfanfalls , Deutsche Ztschr. f. Nervenh. 94:15 ( (Dec.) ) 1926. 28. Foerster and Penfield, W.: Structural Basis of Traumatic Epilepsy and Results of Radical Operation , Brain 53:99 ( (July) ) 1930. 29. Gibbs, F. A.: Frequency with Which Tumors in Various Parts of the Brain Produce Certain Symptoms , Arch. Neurol. & Psychiat. 28:969 ( (Nov.) ) 1932. 30. Groff, R. A.: The Meningioma as a Cause of Epilepsy , Ann. Surg. 101:167, 1935. 31. Guillain, G.; Petit-Dutaillis, D.; Bertrand, I., and Lereboullet, J.: Oligodendrogliome de la région rolandique , Rev. neurol. 1:977, 1932. 32. Hartmann, M.: Ueber einen Fall von Tumor des rechten Schläfenlappens , Arch. f. Psychiat. 94:847, 1931.Crossref 33. Hauptmann, A.: Zur Symptomatologie der Erkrankungen des rechten Schläfenlappens , Deutsche Ztschr. f. Nervenh. 117-119:170, 1931.Crossref 34. Kennedy, F.: Epilepsy and the Convulsive State , Arch. Neurol. & Psychiat. 9:567 ( (May) ) 1923. 35. Kolodny, A.: The Symptomatology of the Tumors of the Temporal Lobe , Brain 51:385, 1928. 36. Symptomatology of Tumor of the Frontal Lobe , Arch. Neurol. & Psychiat. 21:1107 ( (May) ) 1929. 37. Kubitschek, P. E.: The Symptomatology of the Tumors of the Frontal Lobe , Arch. Neurol. & Psychiat. 20:559 ( (Sept.) ) 1928. 38. MacRobert, R. G., and Feinier, L.: The Cause of Epileptic Seizures in Tumors of the Temporosphenoidal Lobe , J. A. M. A. 76:500 ( (Feb. 19) ) 1921. 39. MacRobert and Hens, J. S.: Petit Mai and Aphasia , Tr. Am. Neurol. A. 55:562, 1929. 40. de Martel, T.; Guillaume, J., and Jentzer, A.: Tumeurs temporo-occipitales, dont une tumeur du ventricule latéral , Rev. neurol. 2:63, 1931. 41. de Martel and Vincent, C.: Les hallucinations visuelles dans les tumeurs temporales avec trois observations , Rev. neurol. 1:203, 1930. 42. de Martel Monbrun, A., and Guillaume, J.: Volumineuse tumeur frontale droite (astrocytome fibrillaire kystique). Absence de syndrome focal. Localisation établie par la ventriculographie , Opération. Guérison, Rev. neurol. 1:726, 1933. 43. Martin, J. P.: Two Cases of Oligodendroglioma , Brain 54:330, 1931. 44. Masson, C. B.: The Occurrence of Calcification in Gliomas , Bull. Neurol. Inst. , New York 1:314, 1931. 45. Moniz, E.: Tumeurs cérébrales visible chez les épileptiques , Rev. neurol. 37:18, 1930. 46. Opalski, A.: Un cas de tumeur de la zone cérébrale motrice avec hémiplégie homolatérale sans symptômes croisés , Rev. neurol. 1:369, 1931. 47. Parker, H. L.: Epileptiform Convulsions: The Incidence of Attacks in Cases of Intracranial Tumor , Arch. Neurol. & Psychiat. 23:1032 ( (May) ) 1930. 48. Penfield, W., and Gage, L.: Cerebral Localization of Epileptic Manifestations , Arch. Neurol. & Psychiat. 30:709 ( (Oct.) ) 1933. 49. Pritchard, E. A. B.: Cerebral Tumor as a Cause of Generalized Epileptic Attacks of Long Standing , Lancet 2:842, 1931. 50. Riggs, H. W.: Dangers and Mortality of Ventriculography , Bull. Neurol. Inst. , New York 3:210, 1933. 51. Rochon-Duvigneaud; Schaeffer, de Martel and Guillaume: Gliome frontal kystique droit sans aucun signe de localisation focale. Intervention opératoire. Guérison , Rev. neurol. 1:682, 1933. 52. Rouquier, A.; Lhermitte, J., and Trelles, J.: Hémiplégie de type du hystérique ou pithiatique, manifestation initiale d'un gliome du corps calleux. Etude clinique , Rev. neurol. 1:448, 1932. 53. Sargent, P.: Epilepsy , Brain 44:312, 1931.Crossref 54. Some Observations on Epilepsy , Proc. Roy. Soc. Med. (Sect. Neurol.) 15:1, 1922. 55. Schlesinger, B.: The Syndrome of the Fibrillary Astrocytomas of the Temporal Lobe , Arch. Neurol. & Psychiat. 29:843 ( (April) ) 1933. 56. Spiegel, E. A.: Rindenerregung (Auslösung epileptiformer Anfälle) durch Labyrinthreizung: Versuch einer Lokalisation der corticalen Labyrinthzentren , Ztschr. f. d. ges. Neurol. u. Psychiat. 138:178, 1932. 57. Stauder, K. H.: Epilepsie und Vestibular-apparat , Arch. f. Psychiat. 101:739, 1934. 58. Stone, L.: Paradoxical Symptoms in Right Temporal Lobe Tumor , J. Nerv. & Ment. Dis. 79:1, 1934. 59. Thomas, A.: Tumeur de l'extrémité antérieure du lobe temporal gauche , Rev. neurol. 2:207, 1928. 60. Urechia, C. I., and Retezeanu: Tumeur de la région temporo-occipitale avec crises de "dreamy state," Paris méd. 2:229, 1933. 61. van Bogaert, L.: Attaques de microtéléopsie, attaques uncinées par gliome temporale , J. de neurol. et de psychiat. 28:561, 1928. 62. Van Dessel, Arthur: L'incidence et le processus de calcification dans les gliomes du cerveau , Arch. franco-belges de chir. 28:845, 1925. 63. Van Gehuchten, P., and Morelle, J.: Tumeur du lobe frontal gauche avec aphasie transitoire , J. de neurol. et de psychiat. 31:135, 1931. 64. Vincent, C.: Diagnostic des tumeurs comprimant le lobe frontal , Rev. neurol. 1: 826, 1928. 65. Vincent and Darquier, J.: Tumeur du lobe frontal gauche. Des erreurs de localisation que peuvent entraîner certaines attitudes anormales de la tête , Rev. neurol. 1:758, 1931. 66. Vincent David, M., and Puech, P.: Sur l'aléxie. Production du phénomène à la suite de l'extirpation de la corne occipitale du ventricule latéral gauche , Rev. neurol 1:262, 1930. 67. Tumeur intraventriculaire droite comprimant les tubercules quadrijumeaux postérieurs. Ablation d'une très grande partie. Guérison , Rev. neurol. 1:644, 1930. 68. Sur l'ablation des tumeurs du cerveau par l'électro-coagulation unipolaire , Rev. neurol. 1:843, 1932.

Journal

Archives of Neurology & PsychiatryAmerican Medical Association

Published: Feb 1, 1936

References